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Physiology II > Cardio: Valvular insufficiencies > Flashcards

Cardio: Valvular insufficiencies Flashcards

1
Q

concentric hypertrophy

A

aortic stenosis

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2
Q

Diastole sounds

A

S2 to S1 (Dub to lub)

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3
Q

stenosis

A

valve doesn’t open like it should

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4
Q

opening snap and progression of mitral stenosis

A

as it progresses it closer and closer to the second heart sound

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5
Q

Ejection - valves

A

Mitral closed, aortic open

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6
Q

most commonly heard murmur

A

holosystolic

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7
Q

what causes heart sounds

A

acceleration and deceleration of blood

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8
Q

Splitting of the second heart sound

A

inspiration slows pulmonic closure - we can percieve it as two sounds rather than one

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9
Q

Noise

A

unreated frequencies (eg: heart sounds) - no relationship between fundamental frequency and overtones

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10
Q

aortic area

A

right of sternum (left outflow track sounds are on the right)

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11
Q

what is the main cause of low viscosity in patients

A

anemia- low red cell concentration

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12
Q

pulmonary area

A

left of sternum in 3rd interspace (right outflow sounds are on the left of sternum)

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13
Q

Systole sounds

A

S1 to S2 (Lub to dub)

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14
Q

how do we normally hear 3rd and 4th Heart sound

A

with amplification - if we can hear them otherwise it ususally means something is wrong

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15
Q

Murmus in mitral stenosis

A

Opening sound, Early Diastolic murmur, Presystolic murmur

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16
Q

Separation Requirement

A

Must be by more than 25 msec to be perceived as two sounds (splitting of the second heart sound)

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17
Q

Aortic insufficiency

A

Diastolic lesion (heard in diastole) Eccentric hypertrophy (volume overload - heart pumps twice as much as normal)

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18
Q

Reynold Number

A

how we identify the liklihood of turbulence occuring (Re > 2000 = turbulence and murmurs )

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19
Q

Pulse and heart sounds

A

Upswing in pulse = Lub

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20
Q

2nd heart sound

A

aortic and pulmonic closure - can split (pulmonic is after aortic)

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21
Q

Filling - valves

A

aortic closed, mitral open

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22
Q

Tones

A

integral harmonics - related

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23
Q

insuffiecincy

A

doesn’t close like it should

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24
Q

Collapsing pulse (water-hammer)

A

some blood goes back across the valve . Rapid diastolic run off, ejection against low preload (jerky pulse - full and then collapses, full and then collapses)

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25
Q

severe mitral stenosis

A

no contraction of atria due to long cunduction pathway long term = pulmonary hypertension (end up with right and left sided lesion)

26
Q

4th heart sound

A

Atria contract and get atrial kick- Atrial sound (not enough to hear it very well) - “gallop rhythm”

27
Q

Diastolic lesions

A

occur in filling state of cardiac cycle = mitral stenosis and aortic insufficiency

28
Q

Systolic defects

A

valvular state that ought to be present in systole = mitral insuficiency and aortic stenosis

29
Q

Sound travels best through…

A

stiff structures

30
Q

what causes high Reynold Number

A

when flow across valve is high and low viscosity and small diameter

31
Q

Early diastole murmur

A

happens during rapid ventricular flow (high RE)

32
Q

aortic stensosis (PV)

A

causes pressure overload (pressure axis gets tallker)

33
Q

Anacrotic pulse

A

pulse rises very slowly- Aortic stenosis

34
Q

excentric hypertrophy

A

insufficiencies - will widen the PV curve

35
Q

3rd heart sound

A

rapid ventricular filling (mitral and tricuspid open) - first 1/3 of diastole. Sound from hitting the ventricular wall “Gallop rhythm” - normally don’t hear it (sometimes young adults)

36
Q

RVE vs LVE

A

RVE starts first and ends last

37
Q

1st heart sound

A

mitral and tricuspid closure

38
Q

what pressures disturbed in mitral stenosis

A

atrial and ventricular pressures - as it progresses you get atrial distention

39
Q

High heart rate

A

Systole and diastole moves to 50/50 rather then 1/3 to 2/3

40
Q

Mitral stenosis progression

A

diastolic disorder ( we hear it during diastole)

41
Q

Murmur cause

A

turbulent flow (nonlaminar flow)

42
Q

mitral area

A

apical area in 5th interpace (left)

43
Q

Auxillary mumor mitral insufficncy

A

occurs in DIASTOLE- much more rapid ventricular filling than usual due to regurgitation (high RN) = off cycle flow murmur

44
Q

intensity on auscultation

A

high intesnity have high amplitude- easy to hear (moving large differences), shallow vibrations are less intense

45
Q

regurgitation and incompetence

A

insufficienceys - blood blacks up because the valve didn’t close

46
Q

Tricuspic valve

A

left lower sternal edge

47
Q

Good attenuators (dampeners) in the body

A

Fat and inflated lungs

48
Q

high frequency sound

A

low mass/elastance ratio

49
Q

low frequency sound

A

high mass/elastance ratio

50
Q

opneing sound (mitral valve stenosis)

A

snapping of the leaflet (snap) - slightly later than second heart sound and occurs on inspiration and expiration

51
Q

Aortic stenosis murmur

A

Creciendo decreciendo murmur (up and down in intensity)

52
Q

which lesion has no change in PV area

A

mitral valve stenosis

53
Q

Duration of sound

A

How long was it? soft tissue attenuate (dampen) sound quickly

54
Q

Mitral valve insuficiency

A

Systolic lesion (hear murmur during systole) MC murmur = holosystolic murmur . Eccentric hypertrophy (volume overload- like all insufficiencies)

55
Q

which valves open in systole

A

mitral and atrial

56
Q

holosystolic murmor

A

all through systolole starts after lub and continues to dub

57
Q

Aortic stenosis

A

Systolic lesion. Disrupts relationship between aortic and ventricular pressure (tiny pin hole - have to try and push blood through) = Concentric hypertrophy - high pressure in aota

58
Q

duration requirement

A

takes 1 s after onset to perceive full intensity (in heart sound time 60 bpm = lub every 1 second) = Never hearing them at full amplitude (brain cant keep up)

59
Q

1st heart sound and mitral stenosis

A

gets louder and slightly delayed to QRS

60
Q

Presystolic murmur

A

loose the atrial kick - atria distends in mitral stenosis

Physiology II (17 decks)

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